If you get into compilers and language design, all languages turn into more formalized versions of Lisp mixed with some libraries and macros. Lisp in many ways is little more than a serialization format for a syntax tree, with a DSL for converting that tree into an executable program.
That's both its biggest advantage and disadvantage. It's an advantage in that it can be stretched and flexed to cover any problem domain, by rigging up a language suited to the domain. On the other hand, the fact that it's so flexible means there's less common points of reference for composition in the large. Learning a language for a domain is usually more work than learning a library that uses familiar idioms, even if it is more flexible in the long term. If that domain isn't your bread and butter, a library suits you better.
It comes down to an economic argument, I believe. Some level of centralization is necessary to overcome the transaction costs of fitting lots of little languages together, which each have their own ideas about how things should work. It helps hugely in tooling, debugging, analysis, etc. Syntactic transformation via macros from a high-level language to a lower level isn't enough to create a practical modern language in the large. You need more.
As to the practical applicability of Lisp, I think you can get most of what you need with something like Clojure.